Don’t you just hate it when sides in any argument are taken seemingly without any reference at all to the facts! People – on either side of the divide – appear to be quite happy to argue their position from a position of blind prejudice, without any reference to the facts or to established knowledge.
This absence of well-researched and informed facts seems to have dogged the whole debate about electronic cigarettes – some regarding their invention as the best thing since the discovery of tobacco itself, and others just as vehemently condemning the devices because they offer an alternative to the pleasures derived by smokers.
It comes as a refreshing anchor to the whole debate, therefore, that the German Cancer Research Centre, in Heidelberg has published probably the most authoritative, rigorously scientific study to date about the pros and cons of electronic cigarettes (http://www.dkfz.de/en/presse/download/RS-Vol19-E-Cigarettes-EN.pdf). As befits any scientific report, it is balanced and fairly argued, studiously avoiding the prejudices or hidden agendas of either the pro- or anti- brigades.
The study is long and detailed, extending to many pages of closely argued text, diagrams and graphs. A fair and balanced summary of the entire contents, therefore, is difficult to produce. Nevertheless, here are a few of the more important conclusions reached by the researchers.
The case against
Perhaps the biggest single argument against the use of electronic cigarettes, according to the German Cancer Research Centre, is the fact that many consumers may be in the dark about the precise ingredients of the compounds they are “smoking” and that relatively little is scientifically known about the potential for adverse side-effects. As the researchers say “there are currently no studies available on the effects of long-term use of e-cigarettes”.
This rather knocks a fairly significant hole in the prejudiced arguments of those who claim that the use of e-cigarettes somehow “must” carry short- or longer-term health risks – the evidence simply is not available.
Thus, the reports notes that nicotine-based liquids used in some electronic cigarettes are potentially – again, note the use of that word “potentially” – dangerous, because nicotine is a toxin and is also known to be addictive.
The report also sounds a note of caution about other ingredients that are used even in nicotine-free liquids needed by e-cigarettes. Principally, these are:
- propylene glycol;
- glycerine; and
- various flavourings.
However, the report notes that all these substances have been approved for use in food and that there remains an absence of scientific study or proof one way or the other whether their long-term use when smoked in electronic cigarettes pose any health problem.
With respect to propylene glycol, for instance the researchers acknowledge that the compound has been approved by the U.S. Food and Drug Administration (FDA) as “generally recognized as safe” (GRAS) when ingested as a food ingredient. Inhalation of the chemical when it is used in an electronic cigarette may, of course, be a different matter, but scientifically-based studies have simply not yet been done.
Similar conclusions are reached in respect to the glycerine commonly used in e-cigarettes. It is an oil widely used – and accepted as safe – in a variety of processed foods, although detailed, long-term studies as to its safety when inhaled remain to be done.
The report considers the presence of certain cancer-causing chemicals found in some of the e liquids used in certain e-cigarettes. Even in the very small amounts in which such carcinogens may be present in some electronic cigarettes “it cannot be excluded that using electronic cigarettes increases cancer risk, even though these substances may be present in very small amounts”. In other words, although the risk cannot be excluded, neither has it yet been demonstrated.
When it comes to polluting the air that others may breathe, the report acknowledges that e-cigarettes continue to emit a vapour into the atmosphere that will be inhaled by others in an indoor space. Critically, however, it concludes that “electronic cigarettes produce substantially fewer ultra fine particles than conventional cigarettes” – further study will be necessary before any health issues can be identified for second-hand inhalers of e-cig vapours, although there was a study carried out to measure the effects of ‘passive vaping’ that were a positive for electronic cigarettes.
The case for
In a report commissioned by a cancer research centre, it is perhaps surprising that very little is made of the fact that smoking (conventional or electronic cigarettes) is a pastime enjoyed by millions of people around the world. It follows, therefore, that not much of a connection is made between the pleasure enjoyed by millions and the price they pay in terms of the cancers caused by smoking conventional cigarettes.
Yet it is switch from a potentially very dangerous habit, to one that is – by any estimate – likely to carry far less of a danger, that nevertheless emerges from the German Cancer Research Centre report.
In this respect, the report is unequivocal in asserting that electronic cigarettes can reduce craving and withdrawal symptoms of those trying to give up smoking conventional cigarettes. Furthermore, even those electronic cigarettes which are completely nicotine-free nevertheless reduce the craving to smoke and also alleviate many withdrawal symptoms.
This scientifically-backed study also reaches the conclusion that “some smokers cut down smoking or quit smoking as a result of using e-cigarettes”.
Given such an unequivocal conclusion, it may seem strange, therefore, that the authors of the report then go on to assert that “the efficacy of e-cigarettes as an aid for sustained smoking cessation has not yet been proven” – presumably on the basis that it is not yet known whether those smokers who quit as the result of taking up e-cigarettes might nevertheless return to conventional cigarettes some time in the future. Yet again, it seems, more research is necessary.
Given the present gaps in our knowledge – recognised by the German Cancer Research Centre – about the short- and long-term effects of using e-cigarettes, their final recommendations on the subject seem somewhat draconian, to say the least. In essence they amount to the classification of e-cigarettes themselves and the ingredients consumed as medicines (and therefore, subject to the full force of the law relating to medicines).